Titre du document / Document title

Comparative evaluation of PASCO and National Committee for Clinical Laboratory Standards M27-A broth microdilution methods for antifungal drug susceptibility testing of yeasts

Auteur(s) / Author(s)

ARTHINGTON-SKAGGS B. A. ⁽¹⁾ ; MOTLEY M. ⁽²⁾ ; WARNOCK D. W. ⁽¹⁾ ; MORRISON C. J. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, ETATS-UNIS
⁽²⁾ Morehouse School of Medicine, Atlanta, Georgia 30310, ETATS-UNIS

Résumé / Abstract

The PASCO antifungal susceptibility test system, developed in collaboration with a commercial company, is a broth microdilution assay which is faster and easier to use than the reference broth microdilution test performed according to the National Committee for Clinical Laboratory Standards (NCCLS) document M27-A guidelines. Advantages of the PASCO system include the system's inclusion of quality-controlled, premade antifungal panels containing 10, twofold serial dilutions of drugs and a one-step inoculation system whereby all wells are simultaneously inoculated in a single step. For the prototype panel, we chose eight antifungal agents for in vitro testing (amphotericin B, flucytosine, fluconazole, ketoconazole, itraconazole, clotrimazole, miconazole, and terconazole) and compared the results with those of the NCCLS method for testing 74 yeast isolates (14 Candida albicans, 10 Candida glabrata, 10 Candida tropicalis, 10 Candida krusei, 10 Candida dubliniensis, 10 Candida parapsilosis, and 10 Cryptococcus neoformans isolates). The overall agreements between the methods were 91% for fluconazole, 89% for amphotericin B and ketoconazole, 85% for itraconazole, 80% for flucytosine, 77% for terconazole, 66% for miconazole, and 53% for clotrimazole. In contrast to the M27-A reference method, the PASCO method classified as resistant seven itraconazole-susceptible isolates (9%), two fluconazole-susceptible isolates (3%), and three flucytosine-susceptible isolates (4%), representing 12 major errors. In addition, it classified two fluconazole-resistant isolates (3%) and one flucytosine-resistant isolate (1%) as susceptible, representing three very major errors. Overall, the agreement between the methods was greater than or equal to 80% for four of the seven species tested (C. dubliniensis, C. glabrata, C. krusei, and C. neoformans). The lowest agreement between methods was observed for miconazole and clotrimazole and for C. krusei isolates tested against terconazole. When the data for miconazole and clotrimazole were removed from the analysis, agreement was ≥80% for all seven species tested. Therefore, the PASCO method is a suitable alternative procedure for the testing of the antifungal susceptibilities of the medically important Candida spp. and C. neoformans against a range of antifungal agents with the exceptions only of miconazole and clotrimazole and of terconazole against C. krusei isolates.

Revue / Journal Title

Journal of clinical microbiology   ISSN 0095-1137   CODEN JCMIDW 

Source / Source

2000, vol. 38, n^o6, pp. 2254-2260 (23 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Society for Microbiology, Washington, DC, ETATS-UNIS  (1975) (Revue)

Mots-clés anglais / English Keywords

Candida ; Cryptococcus neoformans ; Drug susceptibility test ; Antifungal agent ; Performance evaluation ; Fungi Imperfecti ; Fungi ; Thallophyta ; Yeast ;

Mots-clés français / French Keywords

Candida ; Cryptococcus neoformans ; Test sensibilité médicamenteuse ; Antifongique ; Evaluation performance ; PASCO ; Fungi Imperfecti ; Fungi ; Thallophyta ; Levure ;

Mots-clés espagnols / Spanish Keywords

Candida ; Cryptococcus neoformans ; Prueba sensibilidad medicamentosa ; Antifúngico ; Evaluación prestación ; Fungi Imperfecti ; Fungi ; Thallophyta ; Levadura ;

Localisation / Location

INIST-CNRS, Cote INIST : 17088, 35400008253776.0380